Hyperuricaemia and development of type 2 diabetes mellitus in Asian population

Abstract

Recently, meta-analysis studies reported that hyperuricaemia is associated with higher incidence of type 2 diabetes mellitus (T2DM), however, there are limited data on the Asian population. The aim of this observational study is to estimate the long-term impact of hyperuricaemia on the new-onset T2DM and cardiovascular events. This study is based on a single-centre, all-comers, and large retrospective cohort. Subjects that visited from January 2004 to February 2014 were enrolled using the electronic database of Korea University Guro Hospital. A total of 10 505 patients without a history of T2DM were analyzed for uric acid, fasting glucose and haemoglobin (Hb) A1c level. Inclusion criteria included both Hb A1c <5.7% and fasting glucose level <100 mg/dL without T2DM. Hyperuricaemia was defined as a uric acid level ≥7.0 mg/dL in men, and ≥6.5 mg/dL in women. To adjust baseline confounders, a propensity score matching (PSM) analysis was performed. The impact of hyperuricaemia on the new-onset T2DM and cardiovascular events were compared with the non-hyperuricaemia during the 5-year clinical follow-up. After PSM, baseline characteristics of both groups were balanced. In a 5-year follow-up, the hyperuricaemia itself was a strong independent predictor of the incidence of new-onset T2DM (HR, 1.78; 95% CI, 1.12 to 2.8). Hyperuricaemia was a strong independent predictor of new-onset T2DM, which suggests a substantial implication for a correlation between uric acid concentration and insulin resistance (or insulin sensitivity). Also, hyperuricaemia is substantially implicated in cardiovascular risks and the further long-term cardiovascular events in the crude population, but it is not an independent predictor of long-term cardiovascular mortality in the matched population.

<p>Sex-Specific Associations of Circulating Uric Acid with Risk of Diabetes Incidence: A Population-Based Cohort Study from Sweden</p>

“…16 A retrospective study consisting of 10,505 participants enrolled at a cardiovascular center without history of diabetes at baseline also found that the risk of diabetes increased when UA increased only in the female subgroup. 17 Although the present study did not find a significant interaction between sex and UA on diabetes incidence, stratified analyses across sex showed that higher circulating UA levels were independently associated with increased risks of diabetes incidence in men but not in women, which were controversial with the previous two reports above. The possible reasons for the conflicting findings between ours and others may be due to: the diabetes incidence rate in men in the present study was relatively higher than that in women as shown in Table 2.…”

“…16 Choi et al also found that hyperuricemia was a significantly independent predictor of diabetes only in the female subgroup. 17 Therefore, there is genuine need to clarify the sex specific associations of circulating UA with diabetes, especially from prospective cohort studies on different ethnic populations.…”

Sex-Specific Association of Serum Uric Acid Level and Change in Hyperuricemia Status with Risk of Type 2 Diabetes Mellitus: A Large Cohort Study in China

“…Serum uric acid (SUA), an end product of the metabolism of purine nucleotides, has been suggested as a risk factor for T2DM in an increasing number of epidemiological studies [ 2 – 6 ]. To our knowledge, some cohort studies have investigated the association but with relatively small sample sizes ranging from 711 to 12,643 and inconsistent findings reported [ 2 – 5 , 7 – 14 ].…”

“…To our knowledge, some cohort studies have investigated the association but with relatively small sample sizes ranging from 711 to 12,643 and inconsistent findings reported [ 2 – 5 , 7 – 14 ]. Evidence on the sex-specific differences in the SUA level-T2DM risk association is limited and has resulted in conflicting findings [ 2 , 5 , 6 , 12 , 15 , 16 ], with studies showing a significant association in both sexes [ 12 ], only women [ 2 ], or only men [ 4 , 5 , 15 ]. Therefore, more studies are warranted to clarify the sex-specific association between SUA level and T2DM risk.…”

Role of serum uric acid in ischemic stroke: A case-control study in Bangladesh

“…SUA level was recorded in mg/dl and can be converted to µmol/L by multiplying with 59.485. Although consensus on the definition of hyperuricemia is scarce [18], serum uric acid levels � 7 mg/dl in men and SUA � 6.5 mg/dl in women was considered as hyperuricemia [19].…”